The opinion of the court was delivered by: Conaboy, District Judge.
On July 25, 2000, the Plaintiffs filed a Complaint in this
case seeking damages for the death of Hannah June Hunsinger. The
Complainants named Penn State Geisinger Health Plan as one of
the Defendants, and based their claims for damages on the
alleged tortious and negligent conduct of the Defendants, which
resulted in the death of Hannah June Hunsinger.
On August 29, 2000 Defendant, Penn State Geisinger Health
Plan, removed this action to this Federal Court. In doing so,
the Defendant argued that "because Plaintiffs' claims for a
delay and a denial of benefits are specifically provided in §
502(a)(1)(B) of the Employee Retirement Income Security Act
(ERISA), 29 U.S.C. § 1132(a)(1)(B), this action is removable to
this court pursuant to the complete preemption exception to the
wellpleaded complaint rule." In addition, Defendant alleged that
"in Count V(B) of their Complaint, Plaintiffs purport to be
bringing their claim against Defendant, Penn State Geisinger
Health Plan, not for a denial of care, but rather on the basis
of the delivery of poor quality of health care." (See Doc. # 1,
Exhibit "A" Paragraph 76).
On November 2, 2000, Plaintiffs filed a motion to remand this
case to the State Court arguing that this is a "medical
malpractice claim" and that there is no federal issue involved
which would require removal to the federal court system. In the
motion to remand, Plaintiffs allege that they "did not seek to
make any claims in this case on the basis of denial of care,
under ERISA, or a breach of fiduciary duty by the health plan."
The Plaintiffs further argue that in Paragraph 76 of the
Complaint, they allege "the plaintiffs bring their claim against
defendant, GHP, not for a denial of care, but rather on the
basis of delivery of poor quality health care which was caused
by the corporate negligence of this HMO company." (Doc. # 21)
On November 15, 2000 the Defendant filed its Answer in
opposition to the Plaintiffs' Motion to Remand. In the Answer to
the Motion to Remand, Defendant argued that contrary to the
Plaintiffs' assertions, the Plaintiffs do, in fact, assert a
claim against the Defendant, Penn State Geisinger Health Plan,
arising under the laws of the United States, § 502(a)(1)(B) of
ERISA, 29 U.S.C. § 1132(a)(1)(B), . . . and further, that
"Section 514 of ERISA, 29 U.S.C. § 1144(a) preempts all of
Plaintiffs' State Law claims against the HMO Defendant". The
Defendant further asserted that in "light of the holding of the
Supreme Court of the United States in Pegram, supra.,
Plaintiffs claims against Defendant, Penn State Geisinger Health
Plan, may be preempted by the Health Maintenance Organization
Act, 42 U.S.C. § 300(e) et seq. (1973)." (Doc. # 23)
The concepts of exemption and removal exist to allow actions
to be transferred to the federal court system when those actions
are obviously based on some federal law or federal legislation.
But the Federal Courts have no jurisdiction in matters where
State authority has been traditionally recognized and such cases
must be remanded to the State Courts unless it is clear that the
parties are acting according to specific federal laws or under
federal authority. Indeed, New York State Conference of Blue
Cross and Blue Shield Plans v. Travelers Ins. Co.,
514 U.S. 645, 115 S.Ct. 1671, 131 L.Ed.2d 695 (1995), instructs that
there is "no ERISA preemption without clear manifestation of
The Defendant proceeded in this removal action under the
supposed authority of Dukes v. U.S. Healthcare, Inc.,
57 F.3d 350 (3d Cir. 1995) (hereinafter Dukes) and In re U.S.
Healthcare, Inc., 193 F.3d 151 (3d Cir. 1999) (hereinafter
Bauman) and more specifically, the recent case of Pegram v.
Herdrich, 530 U.S. 211, 120 S.Ct. 2143, 147 L.Ed.2d 164 (2000).
While acknowledging that the Complaint is generally a tort
claim, alleging medical malpractice — the Defendant argues that
the claim set forth in Section V(B), is one that requires
removal because of allegations of the failure of an HMO
(Defendant) to live up to terms of a plan covered by ERISA, in
that the Defendant HMO allegedly denied the Plaintiff
eligibility for benefits.
The Defendant goes on to argue that this type of claim falls
squarely within the terms of ERISA and that the Plaintiffs are
preempted from bringing such a claim in a State Court.
We find that the Defendant's argument, and particularly, the
reliance on Pegram, is more hope than practical reality in
1. wrongly classifies the Plaintiffs' Complaint which is a
true medical malpractice action and not a fiduciary or ...